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23 Cards in this Set
- Front
- Back
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Distribution of Body Fluids
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Extracellular Fluid
*Plasma 5% *Interstitial Fluid 25% Intracellular fluid 70% |
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Osmolality
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concentration
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Hyperosmolality
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more concentrated compared to something else
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Hypo-smolality
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less concentrated compared to something else
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Colloid Osmotic Pressure
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blood proteins (albumen) act as water magnets drawing water into the vessel
*if not as many proteins (anorexia, liver disease, malnutrition), water leaks out of BV and lowers volume |
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Hydrostatis Pressure
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"garden hose", too much pressure in BV, fluid leaks into cells or interstitial fluid
*may be reverese hydrostatis pressure if low pressure in BV; works in opposition to colloid |
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Volume Gains
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*Ingestion
*Metabolism *IV infusion |
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Volume Losses
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*Respiration
*Skin evaporation *Feces *Urine-obligatory loss of 700cc/day "insensible losses"-breathing, fever |
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Regulatory Mechanisms
ADH (SIADA) |
Made in hypothalamus and stored in posterior pituitary
Saves Water SIADH-Syndrome of inappropriate ADH |
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Other Regulatory Mechanisms
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*Aldosterone-in adrenal cortex: saves Na+
*Thirst-c 1% change in cell size b/c of loss, we experience thirst *GI Tract-reabsorbs water |
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Hypo-osmolar Imbalance
Loss of Sodium |
thiazide diuretics
loss of GI fluid high in sodium |
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Sodium Loss Sx
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*tachycardia
*Wt loss *signs of ECF deficit *sodium of less than 135 (norm 136-145) |
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Hypo-osmolar Imbalance
Gain of Water |
*water intoxication
*water intake in impaired renal function *SIADH D5W & 1/2 NS can lead to hypo-osmosis |
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Water Excess Sx
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Swelling of cells
*headache-no where for brain cells to go *muscle cramps, weakness, fatigue *ECF vol excess sx-edema *Sodium less than 135 b/c it's diluted Results in bounding pulse, need to loose vol, not give more Na+ |
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Hyper-Osmolar Imbalance
Gain of Sodium |
*Hyper osmolar IV solution
*saltwater drowning *hyper-aldosteronism-saves Na *baking soda overdose (alkalinic) |
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Hyper-osmolar Imbalance
Loss of Water |
Vol deficit examples:
*diabetes-diuresis, when glucose is very high, body loses sugar and water in urine *hyperosmolar tube feedings s water |
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Hyper osmolar imbalance Sx
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*serum sodium higher than 145
*decreased reflexes b/c brain cell shrinkage *dehydration |
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Isotonic Deficit Etiology
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Loss of Na & water from ECF
*third spacing-usually to abd., protein starved *hemorrhage *vomitting/diarrhea *profuse diaphoresis |
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Isotonic Deficit Sx
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*wt. loss-from bl volume
*tachycardia/tachypnea *low urine output *postural (orthostatic) hypotension *low grade temp--body needs 800cc/day of intake to maintain normal temp.. *NS, normal hgb |
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Isotonic Deficit Tx
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Isotonic IV fluids
*Lactated Ringers (Na, Cl, K) helps c lactic acid build up from anaerobic metabolism of of O2 loss in blood *Normal saline Oral re-hydration |
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Isotonic Excess Etiology
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gain of both Na and H2O
*CHF *Cirrhosis *Renal Failure *Steroids Ask pt. if thirsty or take Na+ level to help indicate if isotonic |
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Isotonic Excess Sx
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*Wt gain
*pulmonary edema-hydro. pressure *neck vein distention *hypertension *bounding puls *decreased hct-no RBC change *pitting edema-more than 3 secs. |
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Isotonic Excess Tx
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*Diuretics
*Assessment Need to lose both Na and H2O |
